Banded Gastric Bypass: Better Long-Term Results? A Cohort Study with Minimum 5-Year Follow-Up

ABSTRACT Background: Stapled hemorrhoidopexy is associated with less postoperative pain and faster recovery. However, it may be associated with a greater risk of symptomatic recurrence. We hypothesized that undertaking a limited surgical excision of hemorrhoid disease after stapling may be a valid approach for selected patients. Aim: To compare long-term results after stapled hemorrhoidopexy with and without complementation with closed excisional technique. Method: In a retrospective uni-institutional cohort study, sixty-five (29 men) patients underwent stapled hemorrhoidopexy and 21 (13 men) underwent stapled hemorrhoidopexy with excision. The same surgeons operated on all cases. Patients underwent stapled hemorrhoidectomy associated with excisional surgery if symptoms attributable to external hemorrhoid piles were observed preoperatively, or if residual prolapse or bulky external disease was observed after the firing of the stapler. A closed excisional diathermy hemorrhoidectomy without vascular ligation was utilized in all complemented cases. All clinical variables were obtained from a questionnaire evaluation obtained through e-mail, telephone interview, or office follow-up. Results: The median duration of postoperative follow-up was 48.5 (6-40) months. Patients with grades 3 and 4 hemorrhoid disease were operated on more frequently using stapled hemorrhoidopexy complemented with excisional technique (95.2% vs. 55.4%, p=0.001). Regarding respectively stapled hemorrhoidopexy and stapled hemorrhoidopexy complemented with excision, there was no difference between the techniques in relation to symptom recurrence (43% and 33%, p=0.45) and median interval between surgery and symptom recurrence (30 (8-84) and 38.8 (8-65) months, p=0.80). Eight (12.3%) patients were re-operated after stapled hemorrhoidopexy and 2 (9.6%), after hemorrhoidopexy with excision (p=0.78). Patient distribution in both groups according to the degree of postoperative satisfaction was similar (p=0.97). Conclusion: Stapled hemorrhoidopexy combined with an excisional technique was effective for more advanced hemorrhoid disease. The combination may have prevented symptomatic recurrence associated to stapled hemorrhoidopexy alone.

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Influence of the gastric stump’s volume on the long-term results of laparoscopic Roux-en-Y gastric bypass surgery

Grekov s Bulletin of Surgery ◽

10.24884/0042-4625-2021-180-1-81-88 ◽

2021 ◽

Vol 180 (1) ◽

pp. 81-88

Author(s):

A. G. Khitaryan ◽

D. A. Melnikov ◽

A. A. Orekhov ◽

A. V. Mezhunts ◽

S. A. Adizov ◽

...

Keyword(s):

Weight Loss ◽

Gastric Bypass ◽

Weight Gain ◽

Bypass Surgery ◽

Gastric Bypass Surgery ◽

Long Term Results ◽

Gastric Stump ◽

Insufficient Weight Loss

The objective was to retrospectively analyze the dependence of long-term results of laparoscopic Roux-en-Y gastric bypass surgery according to the size of the formed gastric stumpMethods and materials. We retrospectively analyzed the long-term results of 207 morbidly obese patients who underwent laparoscopic Roux-en-Y gastric bypass surgery by two different techniques. The median follow-up was 36 months. Two groups of patients were identified according to the method of formation of the gastric stump: using 2 (1st group) or 3 (2nd group) stapler cassettes and performing of computed tomography volumetry to determine thevolume of the created gastric stump.Results. Statistically significant differences in the volume of the formed gastric stump, depending on the method of operation, were as follows: 23.8 ml (8.9–37.3 ml) in the 1st group and 47.7 ml (31.9–72.8 ml) in the 2nd group (p<0.0001). Significant differences were observed in the following indicators: relapse of weight gain or insufficient weight loss (loss of < 70 % overweight) at median follow-up of 36 months were observed in 2 (2.3 %) and 12 (9.9 %) cases in the 1st and 2nd groups, respectively (p<0.05).Conclusion. We revealed that the formation of the gastric stump of a very small volume by 2 stapler cassettes compared to using 3 stapler cassettes contributes to improving the results in the long-term postoperative period and minimizing the frequency of relapse of weight gain and insufficient weight loss. The restrictive component of the surgery with equal malabsorptive is fundamental for the clinical parameters of its effectiveness, that leads to increasing the frequency of relapses of weight gain and insufficient weight loss in the 2nd group in comparison with the 1st and group of patients (p<0.05). Based on computed tomography volumetry, the volume of a small-sized stomach stump can be reliably measured and, accordingly, weight loss is predicted in the long term after the surgery, as well as the absence of relapses of weight gain or insufficient weight loss.

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Radial club hand treated with soft-tissue distraction and subsequent pin stabilization: mid- to long-term results

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193420916694 ◽

2020 ◽

Vol 45 (7) ◽

pp. 729-736

Author(s):

Georges Pfister ◽

Malo Le Hanneur ◽

Manon Bachy ◽

Franck Fitoussi

Keyword(s):

Cohort Study ◽

Soft Tissue ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Long Term Results ◽

Percutaneous Pinning ◽

Level Of Evidence ◽

Hand Deformities

Radial club hand deformities are commonly treated with arthrolysis to allow centralization of the ulna. In this retrospective cohort study of 31 hands in 28 patients, we aimed to assess the outcomes of correction using progressive distraction and subsequent percutaneous pinning of the wrist with a corrective ulnar osteotomy. Mean follow-up time was 7 years (range 2 to 20). The angulation of the hand–forearm complex was decreased after each step of the procedure. Mean correction of the angulation was 64°, and the residual total forearm–hand angulation was 12° after completion of the surgery. At the time of bony maturity (four patients), all wrists had fused. Fifty-eight reoperations were required in 31 wrists because of pin migration or breakage, and in addition 18 secondary osteotomies of the ulna were performed. From this study we conclude that distraction and pinning provide satisfactory and stable realignment of the wrist to correct the deformity, but this treatment has drawbacks regarding the high number of reoperations and the loss of wrist mobility. Level of evidence: IV

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Banded Sleeve Gastrectomy: Better Long-Term Results? A Long-Term Cohort Study Until 5 Years Follow-Up in Obese and Superobese Patients

Obesity Surgery ◽

10.1007/s11695-018-3248-2 ◽

2018 ◽

Vol 28 (9) ◽

pp. 2687-2695 ◽

Cited By ~ 15

Author(s):

Luc Lemmens ◽

Jelmer Van Den Bossche ◽

Hinali Zaveri ◽

Amit Surve

Keyword(s):

Cohort Study ◽

Sleeve Gastrectomy ◽

Long Term Results ◽

Banded Sleeve Gastrectomy

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Key Time Points After Bariatric Surgery, From Weight Loss To Weight Regain: Long-Term Retrospective Cohort Study

10.21203/rs.3.rs-1064596/v1 ◽

2021 ◽

Author(s):

Mahsa Hatami ◽

Abdolreza Pazouki ◽

Fatemeh Sadat Hosseini-Baharanchi ◽

Ali Kabir

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Gastric Bypass ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Weight Regain ◽

Long Term Results ◽

Time Points

Abstract Background and Objective: Bariatric surgery may lead to an unsuccessful weight loss, weight loss plateau, and even weight regain in different time points after various types of surgery. Despite the numerous studies investigated bariatric surgery-induced weight loss, the long-term results of surgery, after repetitive weight fluctuations, is not really clear and remains as one of the most important concerns. The aim of the present study was to determine the key time points of weight changes after three types of bariatric surgery, and the estimation of five-year weight loss after surgery. Setting: This is a retrospective cohort study including patients with morbid obesity conducted in the obesity clinic of Minimally Invasive Surgery Research Center of Iran University of Medical Sciences. Methods The subjects underwent one of the three types of bariatric surgeries including laparoscopic sleeve gastrectomy (LSG), Roux-en-Y gastric bypass (RYGB), and one anastomosis gastric bypass (OAGB) which had been followed up to five years after surgery. The percentage lost to follow-up was 34% until five-year after surgery. Results The mean %EWL a total of 2567 morbid obese participants (mean age=39.03, mean BMI=45.67) in the first six months after surgery was independent of the type of surgery. Ninth and 24th month after surgery were the times that OAGB and then RYGB induced weight loss sped up rather than LSG, respectively. Weight plateau and weight regain were initiated earlier (at 18th month) and more (18.23% of maximum EWL %) in LSG in the period of five years. The %EWL in time intervals of 3-6, 6-9, and 9-12 months after LSG, RYGB, and OAGB, respectively; could estimate the long-term five years %EWL after surgery. Conclusion OAGB provides the fastest and highest %EWL, and LSG induced the earliest and most weight plateau and weight regain during five years interval post-surgery. The pattern of early weight loss could predict the long-term outcome of bariatric surgery. So early identification of suboptimal weight loss could allow consideration of earlier postoperative intervention to enhance long-term weight loss.

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PL-121 Excellent long-term results after revisional gastric bypass in failed bariatric surgery - a study with 92% five-year follow-up

Surgery for Obesity and Related Diseases ◽

10.1016/j.soard.2011.04.200 ◽

2011 ◽

Vol 7 (3) ◽

pp. 346

Author(s):

Jakob Hedberg ◽

Sven Gustavsson ◽

Magnus Sundbom

Keyword(s):

Bariatric Surgery ◽

Gastric Bypass ◽

Long Term Results ◽

Failed Bariatric Surgery ◽

Revisional Gastric Bypass

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